Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5673 | CA |
NPI | 1003201823 |
---|---|
Provider Name | Mrs. Kris Fujikawa |
First Address | Elk Grove, CA 95757-8125 |
Second Address | Elk Grove, CA 95757-8125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 30/03/2015 |